please help

[fancy1464]

Is an optometrist not qualified to detect glaucoma accurately?  I am scheduling my appointment with an opthamologist as directed by one of the physcians here.but was just wondering if my optometrist noticed a slight difference between my optic nerve cups why would she then assure me that there are no signs of glaucoma and send me out. Does that mean that i should question her expertise and find another doctor?

[berrywoo]

My guess is that glaucoma cannot be easily detected. Yes, there maybe idications of glaucoma if a patient has an elevated IOP and c/d ratio. However, the cause of those things may not be glaucoma. Although, the first possible cause on the list may be glaucoma, it may not be the correct diagnosis, which is why the other tests are called for.
But this is all just a guess since I'm not a doctor. Why not just ask your ophthalmologist?

[walkietalkie]

Thanks Berry. Actually I was curious if glaucoma can be easily detected just by looking into your eyes w/o doing any tests especially as there is no early warnings. But I worry not as my regular doc is a glaucoma specialist!

[berrywoo]

To make an accurate diagnosis you'd need the results of other tests besides just tonometry readings and c/d ratio.

There are no "early" symploms of open angle glaucoma. Most people don't even know about it until damage to the optic nerve has occured and they've got deteriorating visual fields.  

[walkietalkie]

Can glaucoma be easily detected by eye md during routine dilated eye exam w/o doing any special tests?

What are the early symptoms?

Thanks.

[John C Hagan III, MD, FACS, FAAO]

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[berrywoo]

In some areas optometrists have won the right to treat glaucoma patients.

Personally, I feel that this is not good medicine. I feel that there is a place for optometrists, which is to provide refrections and Rxs for corrective lenses. If they see evidence of any problems they should immediately refer the patient to an MD specialist, as the optom is NOT trained nor properly qualified to deal with such issues.

[John C Hagan III, MD, FACS, FAAO]

There is a huge difference between the training of the Eye MD physician ophthalmologist and the non-MD non-physician optometrist. Think the difference between nurse and physician.

I believe that ideally all glaucoma care would be done by ophthalmologists.

JCH MD